Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

The southern region consists of Alabama, Arkansas, Delaware, Dist. Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. Prevalence is highest in the District of Columbia; at 3.61% that's higher than in 138 countries. Florida has the highest HIV positive African American population, 48,500 people, higher than in 109 countries.

Why would sexual behavior among African Americans, homosexual and heterosexual, be more risky than sexual behavior among white Americans? And why would sexual behavior be exceptionally risky in southern states? Or is there more to high HIV prevalence than levels of sexual behavior and types of sexual practice?

To put it another way, do African Americans tend to conform to the many stereotypes about them, such as levels of sexual behavior, types of sexual behavior, attitudes towards sex, etc? Or are there things about the environment, such as living conditions, economic and social conditions and conditions in healthcare facilities, for example, that increase the risk of infection that African Americans face?

It’s hard to know what conditions, exactly, could increase risk to such a degree, or even how. But there certainly are factors that are particularly acute in southern states. The bottom 11 states for life expectancy are in the southern region, as are most of the states with the highest incarceration rates. Almost all the poorest states are in the south. States with the lowest rankings for educational attainment, at all levels, are in the south. Rates of unemployment and homicide rates are high.

Of course, some of the southern states are among the richest by GDP, with the highest household income. But they also have the some of the highest levels of inequality, with several states ranking lowest for economic indicators and several ranking poorest in the US. As a result, most of the states with the lowest Human Development Index are in the southern region. Rates of religiosity are high.